Provider Demographics
NPI:1376002436
Name:DAUER, DANA ALEXIS (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ALEXIS
Last Name:DAUER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9135 SW BARNES RD STE 663
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6683
Mailing Address - Country:US
Mailing Address - Phone:503-297-1078
Mailing Address - Fax:503-292-2176
Practice Address - Street 1:9135 SW BARNES RD STE 663
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6683
Practice Address - Country:US
Practice Address - Phone:503-297-1078
Practice Address - Fax:503-292-2176
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110007288363A00000X
NC001008738363AM0700X
ORPA222857363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1159255OtherNCCPA
ORPA222857OtherOREGON MEDICAL BOARD
NC001008738OtherNORTH CAROLINA MEDICAL BOARD